This is the second post in a blog series showcasing innovations and successes from our Kenya Boresha project – by Geofrey Tanui, David Githinji, Teresa Akun and Catherine Wamuyu from our team in Kenya.
To learn more about the Boresha project and the partnership behind it, read the first blog in our series.
Preterm or premature birth – when a baby is born before 37 weeks of pregnancy – is one of the leading causes of death for children under 5.
Conventional neonatal care requires ventilators and incubators. But in many countries, these are rarely available at the primary health care level. And even when equipment is available, it often isn’t in working condition. Families are then forced to access neonatal services in district hospitals, which can be expensive, putting a heavy economic burden on poor families in low- and middle-income countries.
In these contexts, kangaroo care – an accessible and cost-effective intervention – is a great alternative.
What is kangaroo mother care?
Kangaroo mother care (KMC) is a high-impact, low-tech, cost-effective intervention for saving preterm babies, which families can easily practice even at the community level.
KMC is basically skin-to-skin contact between a mother and her infant, which can be done simply by keeping the baby tied to the mother’s – or mother's – chest, either with a piece of cloth or a harness. It needs to be supported by frequent or exclusive breastfeeding. What helps further is if the mother and baby are discharged early so that they can go back into the care of their families and community.
KMC has proven advantages in increasing newborn babies’ chances of survival by:
- greatly improving neurodevelopment and psycho-emotional wellbeing
- helping with better infant feeding and weight gain
- reducing risks of infection.
It also has considerable benefits for mothers and families – enabling better maternal physical and psychological health and promoting bonding. And critically important, families of preterm babies do not need to become impoverished by healthcare costs for their baby.
KMC is one of the key interventions promoted by Save the Children in the GSK-funded Boresha project in Kenya. We work with the Ministry of Health’s Division of Newborn and Child health, local county teams and healthcare workers to promote the use of KMC. Our team provides training, supportive supervision and mentoring to support health facilities in promoting and implementing KMC. We also conduct assessments to identify resource and capacity gaps and help county-level health facilities to identify effective solutions to barriers to KMC being accepted and implementated.
“KMC is actually a very easy intervention to promote; it does not require a lot of money… Since we started this project, we have increased the use of KMC in the referral hospital and have encouraged other facilities to start promoting and implementing KMC to ease the burden on the referral hospital.” Nancy Gitari, Deputy Nurse in charge of Kerugoya county referral hospital and lead on KMC
Some of the main barriers hindering the implementation of KMC include low awareness among healthcare workers of the benefits of KMC and lack of training. That’s why it’s critical to include KMC on any health worker’s training curriculum.
Health workers then need a supportive environment with adequate mentoring and supervision to help them confidently promote, implement and scale up KMC as part of routine neonatal services.
Gladys Wanjala, a nurse from Siboti Health Centre in Bungoma county, was trained in KMC as part of the Save the Children–GSK Boresha project. She was able to support and encourage John and Anne (pictured below) to both use KMC with their preterm twins and for Anne to exclusively breastfeed the babies. Well trained health workers can ensure that lifesaving interventions like KMC are accepted and used in communities, increasing the chances of child survival in high-risk contexts.
John and Anne gave their preterm twins kangaroo care.
Building a network
Our team in Kenya has been supporting the Ministry of Health and its newborn child health division to create a community of practice amongst health workers and establish a network of champions in counties implementing KMC services.
KMC champions in Kitui, for example, are a group of health workers and mothers who advocate for KMC by promoting peer-to-peer learning, creating a supportive environment, and increasing acceptance of KMC among health workers and the community.
The community of practice they are part of enables KMC experts and aspiring practitioners from different counties to share information, best practices, challenges, and recommendations for improvement. The network has enabled KMC to be scaled-up across 17 counties.
“The KMC champions network has motivated us. We learn a lot from other counties where we share photos and achievements” Christine Sammy, County Child Health Coordinator
Since 2014, the Save the Children–GSK program in Kenya has enabled the Ministry of Health to greatly expand KMC implementation in the country and save countless babies’ lives.
With the shared ambition of ending preventable deaths for all children under 5, the Boresha programme in Kenya is a partnership that has leveraged the unique capabilities of GSK and Save the Children to deliver measurable impact for the hardest-to-reach children.
To learn more about the Boresha project and the partnership behind it, read the first post in our blog series.
The image at the top of the page shows a premature baby in Kenya getting kangaroo care (Siegfried Modola/Save the Children).
